Campbell County Death Certificates

CERTIFICATE OF DEATH
STATE OF TENNESSEE
DEPARTMENT OF PUBLIC HEALTH
DIVISION OF VITAL STATISTICS

 
Mary Elizabeth Walden
Reg. Number:  left blank; Reg. District: 40705
Certificate Number: 63-03037

Name: Mary Elizabeth Walden
Residence: Jellico Campbell Co Tn
Sex: Female
Race: White
Date of Birth: 05 Dec 1877
Place of Birth: Temm
Date of Death: 28 Feb 1963
Place of Death: Jellico Campbell Co Tn
Age: 85
Marital Status: Married
Spouse, if living: Left Blank
Age of Spouse, if living:
If Veteran, Name of War:
Social Security Number: left blank
Occupation: Housewife
Industry or Business: (left blank)
Father's Full Name: Frank McCully
Father's Birthplace:
Mother's Full Maiden Name: Delilah Lawson
Mother's Birthplace:
Cause of Death: Dead on Arrival-Cause Unk
  • Due to: (left blank)
  • Other conditions: (left blank)
  • Operation?: (left blank)
  • Autopsy?: (left blank)
If death was due to external causes, fill in the following:
  • Accident, Suicide, or Homicide: (left blank)
  • Date of Occurrence:
  • Where did the injury occur: (left blank)
  • Did injury occur in or about home, on farm, in industrial place, in public place?: (left blank)
  • While at work: (left blank)
  • Means of Injury: (left blank)
Informant: Everet Walden
Informant Address: Jellico R-2
Burial, Removal, or Cremation: Jellico Cemetary, Jellico Tn
Date: 02 Mar 1963
Undertaker: Llewellyn Fun
Address: Jellico Tn
By: Jerry R Llewellyn
Date Filed: 12 May 1963
Registrar: Margaret H Ayers, Dep. Reg.
Signature: Joseph Fox, MD
Address: Jellico Tn

Submitter's Name: Joyce A Williams
Submitter's Email: wjwill3@bellsouth.net
Relationship to the Deceased: granddaughter

Comments: Wife of William Wiley Walden and daughter of James Franklin McCullah and Delia Lawson



 


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